Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917801 (insomnia)
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The treatment of obesity is one of the major measures available today in the field of preventive medicine. In particular, the coronary epidemic of Western civilisation would be halted, and most cases of maturity-onset diabetes prevented, if obesity were to be treated effectively. Anorectic drugs act mainly on the satiety centre in the hypothalamus to produce anorexia. They also have various metabolic effects involving fat and carbohydrate metabolism, but many of these may be secondary to loss of weight. Most of the drugs are related directly or indirectly to amphetamine and in addition act by increasing general physical activity. Anorectic drugs tend to lose their effect after some months, and part of this reduction in effect may be due to chemical alterations produced by the drugs in the brain. All the drugs, with the exception of fenfluramine, have a stimulant effect on the central nervous system in some individuals, resulting in restlessness and nervousness, irritability and insomnia. Fenfluramine commonly produces drowsiness in normal doses, but has stimulant effects with overdosage. Dexamphetamine, phenmetrazine and benzphetamine all tend to cause euphoria and the risk of addiction is therefore considerable. Euphoria occasionally occurs with diethylpropion, phentermine and chlorphentermine, but to a much lesser extent. Side-effects also occur due to sympathetic stimulation and gastro-intestinal irritation. These side-effects may cause some individuals to stop taking the drug, but are never serious or dangerous. Drug interactions may occur with monoamine oxidase inhibitors and to a clinically unimportant extent, with antihypertensive drugs. The anorectic drugs have a very definite part to play in the treatment of obesity, mainly for those individuals who have altered their eating habits but have come to a plateau of weight which they find difficult to get below. The drugs are best given in a long-acting form and can safely be continued as long as weight loss persists, provided that the clinician exercises careful supervision. Dexamphetamine, phenmetrazine and benzphetamine should rarely be used because of the danger of addiction, and chlorphentermine is potentially hazardous for long-term use. Diethylpropion emerges as the drug of first choice, as fenfluramine has a tendency to cause depression and has a higher incidence of side-effects. Fenfluramine is mainly useful for people who are especially tense and for obese maturity-onset diabetics who have been unable to lose weight with the biguanides. Mazindol and phentermine appear to be useful as alternative drugs.
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PMID:Anorectic drugs: use in general practice. 78 35

Pathologically increased apetite is the most tormenting symptom of overweight conditions and therefore, along with dietetic treatment which plays an essential role, it is most expedient to resort to anorectic drugs also. Recently, the Sanorex preparation (Mazindol, Teronak, AN 448 degrees--imidazo-isoindole derivative having a tricyclic structure) is ever more extensively used. The action of the drug is studied in a series of 32 obesity individuals under sanatorial conditions and normocaloric diet, over a period of twenty seven days. The new preparation Sanorex which causes aversion to food, given in small doses, accounts for prompt and reliable control of the apetite--9590 kg reduction, 0,362 kg mean daily weight loss (p less than 0,05), and equal intensity of weight loss in either of the sexes (p less than 0,01). Side effects such as dryness in the mouth, very strong and moderate thurst, insomnia, superficial sleep, headache, elevated excitability, tachycardia, general feebleness are transitory, subside within two weeks, and are tolerated comparatively well by the patients included in the series. Sanorex administration may be recommended provided due consideration is given to the usual limitations implied by the continuous use of new drugs.
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PMID:[Treatment of obesity with the anoretic Sanorex]. 80 32